The Amputation Reduction and Compassion Act of 2025, or ARC Act of 2025, seeks to significantly reduce the incidence of amputations caused by Peripheral Artery Disease (PAD). PAD, a form of atherosclerosis affecting the legs, affects an estimated 21 million Americans and disproportionately leads to avoidable amputations, particularly among minority populations. The bill highlights that early screening and detection are cost-effective and can substantially reduce amputations and deaths.

To address the lack of public and professional awareness, the bill establishes a Peripheral Artery Disease Education Program. This program, led by the Secretary of Health and Human Services through the CDC, CMS, and HRSA, will develop educational initiatives and outreach strategies. Its goal is to inform healthcare professionals and the public about PAD and methods to reduce amputations, with a specific focus on at-risk populations. The program is authorized $6 million annually from fiscal years 2026 through 2030.

A key provision of the ARC Act is the expansion of Medicare coverage for PAD screening tests for at-risk beneficiaries, effective January 1, 2026. These tests, including ankle-brachial index testing and arterial duplex scans, will be covered without the imposition of cost-sharing requirements, meaning no deductibles or copayments. At-risk beneficiaries include individuals aged 65 or older, those aged 50-64 with atherosclerosis risk factors, younger individuals with diabetes and a risk factor, or those with known atherosclerotic disease in other vascular beds.

Similarly, the bill mandates Medicaid coverage for PAD screening tests for at-risk beneficiaries, also without cost-sharing. The definitions for "peripheral artery disease screening test" and "at-risk beneficiary" largely mirror those for Medicare. Furthermore, the Secretary of HHS is directed to develop and implement quality measures for nontraumatic, lower-limb major amputations. These measures will encourage diagnostic screening, including PAD screening, and promote alternative treatments like revascularization, integrating into existing Medicare quality reporting programs.

Finally, the legislation calls for the establishment and testing of an Amputation Prevention Pilot Program. This program, to be tested by the Center for Medicare and Medicaid Innovation, aims to promote voluntary, nontraumatic lower-limb major amputation prevention at various healthcare facilities. It will focus on increasing access to prevention services, reducing amputation rates, and lowering costs through patient risk modification, early screening and detection, PAD testing and treatment, and improved care coordination for high-risk individuals.